Original Research| Volume 183, P60-68, April 2023

Incidence, mortality and trends of cutaneous squamous cell carcinoma in Germany, the Netherlands, and Scotland

Published:January 27, 2023DOI:


      • Age standardised incidence rates separated of cutaneous squamous cell carcinoma from four European registries were analysed.
      • An annual increase between +2.4% and +5.7% was observed over three decades.
      • Highest increases occurred in ages ≥60, especially in men ≥80.
      • Age-standardised mortality rates are rising in Germany and Scotland.
      • In extrapolations until 2044, an increase up to 5-fold in ages ≥60 is expected.


      Aim of the study

      Cutaneous squamous cell carcinoma (cSCC) incidences are increasing but scarcely available separated. We analysed incidence rates of cSCC over three decades with an extrapolation to 2040.


      Cancer registries from the Netherlands, Scotland and two federal states of Germany (Saarland/Schleswig-Holstein) were sourced for separate cSCC incidence data. Incidence and mortality trends between 1989/90 and 2020 were assessed using Joinpoint regression models. Modified age-period-cohort models were applied to predict incidence rates up to 2044. Rates were age-standardised using the new European standard population (2013).


      Age-standardised incidence rates (ASIR, per 100,000 persons per year) increased in all populations. The annual percent increase ranged between 2.4% and 5.7%. The highest increase occurred in the age groups ≥60 years, especially in men aged ≥80 years, with a three to 5-fold increase. Extrapolations up to 2044 showed an unrestrained increase in incidence rates in all countries investigated. Age-standardised mortality rates (ASMR) showed slight increases between 1.4 and 3.2% per year in Saarland and Schleswig-Holstein for both sexes and for men in Scotland. For the Netherlands, ASMRs remained stable for women but declined for men.


      There was a continuous increase of cSCC incidence over three decades with no tendency for levelling-off, especially in the older populations as males ≥80 years. Extrapolations point to a further increasing number of cSCC up to 2044, especially among ≥60 years. This will have a significant impact on the current and future burden on dermatologic health care which will be faced with major challenges.



      NMSC (non-melanoma skin cancer), BCC (basal cell carcinoma), cSCC (cutaneous squamous cell carcinoma), ASIR (age standardised incidence rate), ASMR (age standardised mortality rate), AAPC (average annual percentage change), EAPC (estimated annual percentage change), ICD (International Statistical Classification of Diseases and Related Health Problems)
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